Endocrine dysfunction induced by immune checkpoint inhibitors: Practical recommendations for diagnosis and clinical management

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. However, because ICIs block coinhibitory molecules on T cells and other immune cells, unleashing them to mediate tumor cell killing, they also can disrupt the maintenance of immunological tolerance to self‐antigens. Compared with chemotherapy, ICIs have a different toxicity profile, especially the occurrence of autoimmune‐like manifestations against multiple organ systems, including endocrine glands, commonly referred to as immune‐related adverse events. The aim of this review was to provide practical recommendations regarding the proper assessment and clinical management related to the new onset of endocrinopathies after the use of ICIs in patients with cancer. Cancer 2018;124:1111‐21. © 2018 American Cancer Society. The risk of endocrine dysfunction resulting from immune checkpoint blockade differs among different immune checkpoint inhibitor (ICI) regimens, and is higher with combination therapy. Early recognition of endocrine dysfunction resulting from ICI use is important to prevent life‐threatening complications. Herein, the authors review practical recommendations regarding the proper assessment and clinical management related to the new onset of endocrinopathies after the use of ICIs in patients with cancer.